Extension and reduction appliance



March 13, 1945. HAYNES 2,371,519

' EXTENSION AND REDUCTION APPLIANCE Filed Nov. 12, 1942 3 Sheets-Sheet ljln-uqufor/ fififfa zaes March 13, 1945. H. HAYNES EXTENSION ANDREDUCTION APPLIANCE 3 Sheets-Sheet 2 Filed Nov. 12, 1942 March 13, 1945.H. HAYNES 2,371,519

EXTENSION AND REDUCTION APPLIANCE Filed Nov.. 12, 1942 s Sheets-Sheet sl Patented Mar. 13, 1945 news-an. hashes, mausttfit,

Application November 12, 19 12; etail No; 4655354 realms; tenants" rThis invention-relates to extension and reduc tion'apparatusgenerallybutis particularly intended for use in conjunction with the installation ofthe typed-ambulatory splint'shown' in my Patent #-2,2'3'8,'870, grantedApril 15, 1941;

A primary object of the-invention resides-in theprovisionof a small andlight weight 'mechanism-of this general. type" which may conven Figure'9 is a persptiveview or oneoft-He basemembeis oftheskleta-l splint;

iently'rest.uponthe-limb-of apatient while being attached to thesplint'pa rtsduring the process of aligning the, bone fragments; whereby theap= paratus is not onlyreadilyportable but also the operativemechanismis relatively close'to the bone so as to. reduce to a minimum the strainapplied to the structural-parts of the apparatus and likewise theamountof yield or give of the parts, thereby promoting lightn'essofapparatus and permanency of adjustment'of the bone frag- Referrin'g'ptothe drawings-in' 'gr'ater' detail the numeral I 'in'dicatesa palm:paiallelrods; which: in conjunction iviith'f the cro'ss bar and handle-2 provide a" supporting rranie" tor the operative partsof'theappliancez"The rods lare preferably of tubularfiornffo'r the sake of'lightness; andare threadedtat oiie end; as T indicated ments. The lightness of theapparatus, rap:

proximately 9- pounds, permits it to be readily supported on thelimb-ofa patient through the medium of skeletal screws, without becomingburdensome, and permits thejlimbtobe moved to various positions iorviewing through a' fiuo'roscope. a

Another object of the invention consists in providing a simple; butextremely accurate -ap"-' pliance for properly-aligning the bonefragments of-an-injured limb. v

A'further object of the invention resides in the provision ofsuchadevice in the nature of a precision instrument whereby the bonefragmentsmay be minutely'adjusted in any desired dir'e'c' tion so-as toaccuratelyalign'the fragments and cause a proper mating of-the abuttingends-.

Another object of theinventio'n resides in the provision of; an'extension and reduction ap-' pliance whic'h may'be quickly andeasilyapplied, to the skeletally attached base members shown in theabove-mentioned patent. e

Other objects and-advantages 'of the invention I will be apparent fromthe following descriptionwhen taken inhonnectionwith the accompanyingdrawings, in which,

Figure l is a perspective view'of' the appliance. Figure 2-1 line 2 '2Figure 3-. L i Figure 3 is atop plan view of the apparatus.- ,Figure 4isa transverse sectionaliview -taken-online 4-4 of Figure 3; v

Figure 5 is an fenlarged sectional-detail view through the carriage atthe right of Figures 1 and 2; r

' i'gu-rejfi isanenlarged detailsectionalviewofr one of the clamps,taken on line B-Bof Figure 5.

ju-stmentofone"of'themarriages; The 'o'ther e'rid of one of thebars"is"ptefrably' provided" with arseries of transverse notches @foicooperation" with'a latch orithe other-carriage toprovidea relativelyrough adjustment of "the latter.-

The operative part of the appliance-comprises a pair l of carriages '5and 6." which are archedas indicatedinFigures vrand '2 tb permitof"suspend inga pair-of clampingmembers"iritsubstantially theip'l'aneof-the framelazr r {Ihecarriages .5 and" 6 are slldably' mountedon therods 5| anditangentiallymounted on the "arch" offcarriaeerfiiisa plate lpwthilea similar plate 8; issimilar1y{mounted on the: arch of carriage6. The: plate 1 gismrovided WItHaI'I downward feiF tension '9 which isID in the; arch" portion of carriage 5' and hld therein by means 'of a;washer Handwnut l2 threaded onto a threaded-portion'of theex'tension 9;The archedportion'of th'eparri'agei is=pro vided with a pair of arcuateracks "l3, and the':

plate 1 carries a. "shaft l4 provided with a'pair or s a verticalsectional-view taken on to :cooperate with :an:

pinionsii for cooperation with therack's l3;

Theshaft I4 is adapted; tobe'rotated by means: oi ahand: wheel; l6whiblifjisfkyd'tdtheShaft H by. means, 'of'a pair of'pinsrd lfcarri'edby the shaft or other suitableimearlsi Ac'cid ehtal move"- mentofthevplate r1 is-preventeu: by n'ieans or a. pin l8 onrthehub-ofwheel'ilfi whi'ch is adapted annularseries ofi'apertures I79 in-"a'is'ideiof'the;.rplate""1:;.-at sp'rin'gzflu within the hub-of-whee lylGnormally'forcesithe' pint'l8 in one of the apertures"! Q; and it' willbe apparent that in order to adjust the plate I it is necessaryto' firstwithd-raw the -pin; from alts aperture 2 l 9 against the pressureofspring- 20;" w 1 Pivotally mountedionthezupper side of .plate'l, as;bymeans ;of pivot piniZ |,--is*an L-"shaped: arm" 23; ene portion,oftjher'arm" extending ivertical'ly downwardly towardfthe plane of theframe "l 2."

received, inan elongated slot tends horizontally of the plate 1 and hasswiveled thereon a pin 23 in which is threaded a screw 24. The screw 24is rotatably mounted in a bearing 24' swivelled on a portion of plate 1and is provided with an operating wheel or handle 25. It will thus beapparent that by operating the wheel 25 in the proper direction the arm22 may be adjusted about its pivot 2| in the desired direction.

Pivoted upon a horizontal pivot 26 on the lower end of theverticalrportion of arm 22 is a clamp for rigidly gripping one of theskeletal base members 21 of the skeletal splint heretofore referred to.This clamp comprises a plate 28 rotatably mounted on the pivot shaft 26but fixed against sliding movement thereon, and a second plate 30slidably mounted on shaft 26 arid caused to turn therewith by reason ofa pin 3| fixed to plate 28 and extending through an aperture 32 in plate36. The plates 28 and 38 are provided with gripping jaws 33 and 33' attheir lower ends and are normally held in open position by means of acoil spring 34 encircling shaft 26 and engaging the inner faces of theplates 28 and 38. Pivotally mounted on an end of shaft 26, exterior ofthe sliding plate 30, is a cam 35 for forcing the clamping plate 36toward the fixed plate 28 against the pressure of spring 34, and anadjustable stop screw 36 is mounted on plate to limit the inwardmovement of the upper portion of the plate and to provide a definite andrigid gripping action in the lower portion thereof. In order toadjust-the clamp 28-3ll about it horizontal-pivot a threaded sleeve 31is pivoted to the plate 28, and cooperates with a threaded bolt 38swiveled to a boss on arm 22 as by means of pin 39. The bolt 38 isprovided with an operating knob 40 and, as will be obvious, a rotationof the knob in either direction will cause a movement of the clampupwardly or downwardly, as the case may be. a

As heretofore mentioned, the carriage 5 is longitudinally adjustablealong the frame l-2, and in order to lock the carriage in its adjustedposition, a pin 41 is mounted for vertical sliding movement in anenlargement on the carriage, and is operated by means of a pivotedhandle 42. ,The free end of pin cooperates with the notches 4 on one ofthe rods 1 and is normally held in looking position by means of a spring43 interposed between the carriage and handle 42.

The carriage 6 and its related parts is quite similar to carriage 5 andthe parts carried thereby, and it will therefore suflice to merelydescribe the manner in which these two elements of the appliance differ.1

The plate 8 is provided with a downward extension 44 which passesthrough an elongated slot 45 in the arched portion of carriage 6.Extending through the plate- 8 and threaded to a shoe 45' slidablymounted on extension 44 is a bolt 46. The shoe 45 is provided witharcuate portions 41 adapted to engage the underside of carriage 6, andthe'bolt46 is providedwith a. shoulder 48 adapted to engage the uppersurface of the plate 8. By tightening up on bolt 46 it will be apparentthat the. plate 8 may be secured in any position to which adjusted alongthe arch f carriage 6.

.The carriage 6 and plate 8 are provided with a clamp and adjustingmeans therefor identical with those previously described in connectionwith carriage 5, except that the horizontal portion of the arm 22'isprovided with an arcuate slot 49 50 that the arm may be rotated aboutits pivot without interference from the clamping bolt 46 carried byplate 8 on which the arm is pivoted.

The carriage 8 is mounted for a micrometer adjustment along the rods I,and to this end wheels 50 which are rotatably mounted on the ends ofcarriage 6 and partly housed within are threaded on the threads of therods I. These wheels are of bevel gear form as indicated at 5! andcooperate with similar gears 52 fixed to the outer ends of shafts 53.These shafts are rotatably mounted in bearings on the underside ofcarriage 6, and are provided with bevel gears 54 at their inner endswhich cooperate with a common bevel gear 55 mounted on a shaft 56extending longitudinally of the appliance and at right angles totheshafts 53. The shaft 56 is rotatably mounted in bearings on theunderside of carriage 6 and is provided with an operating knob 51. Byrotating this knob in either direction a rotary movement is imparted tothreaded I wheels 56, thereby causing the wheels, and the carriage 6 onwhich they are mounted, to travel along the frame I-2. Because of thethreaded connectionsbetween these parts it will be apparent that veryminute adjustments may be made when necessary.

As heretofore mentioned, the skeletal splint with which the presentappliance may be used is of the type fully disclosed in Patent #2238370.However, a brief description of the splint will be conducive to acomplete understanding of the operation of the reduction apparatus.

A portion of the injured limb to be operated upon is indicated in dottedoutline in'Figure 1. Attached to the two fragments of the bone, as bymeans of skeletal screws A, is the pair of base members or blocks 21.These blocks 21 are rigidly attached to the shafts or upper portions ofthe screw A by means of set screws B and it is with these skeletal basemembers that the present extension and reduction appliance cooperates.The gripping jaws 3333' are rigidly clamped to the blocks 21 and thelatter serve in effect as handles by means of which the bone fragmentsare brought into alignment and proper matingposition. Thereafter theextensible rods C are clamped to the ball portions'D of the blocks so asto fixedly retain the bone fragments in their adjusted positions afterthe extension and reduction appliance is detached from the blocks 21.

It is believed that the operation of the present apparatus will bereadily apparent to those skilled in the art. After the skeletal basemembers 21 have been secured to the bone fragments the frame l-2 isplaced over the limb of the patient. Adjustment of the clamps 33-33 tothe base members 21 may be made by adjusting either or both of thecarriages 5 and 6 along the frame i-Z and by suitably rotating theadjustingknobs, on these carriages. After these adjustments, the clampsmay be quickly and rigidly secured to the members 21 by merely operatingthe cams 35 against the pressure of springs 34.

The-fracture may now be'reduced by adjusting the carriage 6 through themedium of the knob 51 and the transmission devices therefrom to thethreaded wheels 50 which cooperate with the threaded rods l--l. reducedthe bone fragments may be brought into their final and correct positionsby suitably adjusting the plates 1 and 8, along the arches of thecarriages, and by rotating the knobs 25 and 40 to move the blocks in thevarious planes to After the fracture has been obtain exact positioningof the bone fragments. Thereafter the carriage 6 may be moved towardcarriage by rotatingknob 57 so as to bring the ends of the bonefragments into abutting relationship. It is to be understood of coursethat these various adjustments are to be made in conjunction with thefrequent use of a fluoroscope so as to determine the relative positionof the bone fragments from time to time. The extreme lightness of theapparatus and its support on the patients limb through the medium of theskeletal screws, permits the patients limb to be moved to variouspositions so that the fracture may be viewed through the fiuoroscopefrom various angles.

From the foregoing description and the attached drawings it will beapparent that the appliance is relatively small and light in weight;that no cumbersome base or supporting standard is necessary to itseflicient operation; and that when mounted on the base members and readyfor aligning the bone fragments it is quite close to the limb, therebyreducing to a minimum any leverage action of the operative parts of themechanism and also reducing any give or yield of the parts and promotingaccuracy of adjustment of the bone fragments.

In accordance with the patent statutes I have described what I nowbelieve to be the preferred form of construction of the apparatus, butinasmuch as various changes may be made in structural details withoutdeparting from the spirit of the invention it is intended that all suchchanges be included within the scope of the appended claims.

What is claimed is:

1. An extension and reduction apparatus for use in conjunction with anambulatory splint, including a frame and two carriages movably mountedthereon for adjustment toward and from each other, a clamp carried byeach car-' riage, and each clamp adapted to hold a skeletal base memberhaving skeletal pins engaging the bone fragments, means for adjustingthe carriages toward and from each other, and means associated with eachcarriage to adjust the said clamps and the skeletal base members carriedthereby to reduce the fracture and properly position and mate the bonefragments, and means carried by each of said skeletal base members forsecuring thereto the ends of rods to form an ambulatory splint,whereupon the extension and reduction apparatus is removed by releasingsaid clamps from said skeletal base members.

2. An extension and reduction apparatus for use in conjunction with anambulatory splint,

including a frame and two carriages movably mounted thereon foradjustment toward and from each other, a clamp carried by each carriage,and each clamp adapted to holda skeletal base member having skeletalpins engaging the bone fragments, means for adjusting the carriagestoward and from each other,and means I associated with each carriage toadjust the clamps and the skeletal base members carried thereby toreduce the fracture and properly position and mate the bone fragments,and ballshaped members carried by each of said skeletal base members forsecuring thereto the ends of rods to form an ambulatory splint,whereupon the extension and reduction apparatus is removed by releasingsaid clamps from said skeletal base members.

- 3. An extension and reduction apparatus for use in conjunction with anambulatory splint,

including a frame and two carriages movably mounted thereon foradjustment toward and from each other, each of the carriages beingarched above the said frame, a clamp suspended from each carriage insubstantially the plane of said frame, each clamp adapted to hold askeletal base member having skeletal pins engaging the bone fragments,means for adjusting thecarriages toward and from each other, and meansassociated with each carriage to adjust the said clamps and the skeletalbase member carried thereby to reduce the fracture and properly positionand mate the bone fragments, and means carried by each of said skeletalbase members for securing thereto the ends of rods to form an ambulatorysplint, whereupon the extension and reduction apparatus is removed byreleasing said clamps from said skeletal base members.

4. An extension and reduction apparatus for use in conjunction with anambulatory splint, including a frame and two carriages movably mountedthereon for adjustment toward and from each other, each of the carriagesbeing arched above the said frame, a clamp suspended from each carriagein substantially theplane of said frame, means for adjusting thesuspending means along the arch of the carriages, means for adjustablyraising and lowering the clamps, means for adjusting the clampslaterally, means for adjusting thecarriages toward and from each other,each clamp adapted to hold a skeletal base member having skeletal pinsengaging the bone fragments, and means carried by each of said skeletalbase members for securing thereto the ends ofrods to form an ambulatorysplint, whereupon the extension and reduction apparatus is removed byreleasing said clamps from said skeletal base members.

HERBERT H. HAYNES.

